Do you know the number one cause of nonfatal choking incidents that lead to emergency room visits in America? According to a study in the August 2013 issue of Pediatrics, hard candy is listed as the top offender—with over 60% of choking episodes occurring in children under age four. This is an interesting point, as many parents withhold hard candy only from babies and toddlers. According to the study, older children are at risk of choking as well. Common choking hazards include meat (hot dogs are at the top of the list), bones, nuts, popcorn kernels, gum, fruits, vegetables, cheese chunks, and other types of candy.

Eliminate hard or chewy candy from children’s diets. Children are not ready to figure out how to chew and swallow hard candy. Those who appear to eat hard candy with ease may, unfortunately, choke if distracted or if a sizable chunk is consumed.

Do not give large pieces of fruit or vegetables. Chop them, whether fresh or cooked. For babies less than nine months old, puree their fruits and vegetables. Toddlers and children should eat small pieces that are not too hard.

Cut up meat and cheese into small pieces. Babies less than nine months old should eat pureed meat and cheese. For toddlers and children, give them small, tender, easy-to-chew pieces of meat or cheese. Soft meat and cheese may be shredded by hand.

Sift and remove popcorn kernels. Do not trust the safety of any popcorn served, whether bagged, popped in the microwave, or purchased at a movie. Discard the kernels yourself.

Serve meat boneless. Despite the “eat meat and spit out bones” example set by cartoon characters, no one should tear meat from a bone. Separate meat from bones, assuring that no pieces of bone are left behind.

Do not give your child gum until age 5 or later. Even at this older age, children should not chew gum during exercise, running, or sporting activities.

Give nuts in paste form early. Many commercially available nut butters are available. If you are feeling creative, recipes are available to make your own fresh nut butters.

Encourage your child to eat one piece at a time. Most children will try to cram more than one piece of food in their mouth at a time. This commonly causes choking due to the abundance of food in the mouth.

The takeaway for choking safety advice? To promote choking safety for babies and toddlers, pay attention to the foods given as well as their texture and quantity. To find a course for CPR and choking treatment, contact a local hospital in your area, the American Red Cross, or the American Heart Association.